2. Referred — Risk conditions discovered in wellness visits that are eligible for further action and reimbursement, mostly at future times. These can be reimbursed for specific in-house provider actions (not referrals) termed counseling and therapy.

They include: (no co-pay / average annual rates)

• G0389 — $110 — Abdominal Aortic Aneurysm (AAA) screen(only if referred by condition from G0402, once in lifetime during Part B first 12 months)

These benefits may be provided when a patient answers positively on the Health Risk Assessment or displays conditions that indicate a need such as high blood pressure, overweight, etc. for cardiovascular disease or obesity.

3. Asymptomatic Screens or Tests — Annual or other CMS-scheduled benefits with no copay that may be provided at the AWV or other E&M encounter for all Part B eligible Medicare beneficiaries.

The case for a six-month interval schedule may be that if patient answers negatively to the bundled review questions for alcohol or depression conditions at the time of the AWV or Initial Preventative Physical Examination (IPPE) visit, an additional annual screen at that time may not be relevant, although allowed by CMS. The situation may be that the patient then experiences a change in behavior and develops an alcoholic or depression condition which could then be detected and treated with a six-month interval schedule.

Cancer Network Blog

This blog is a space for commentary on issues facing the oncology community. Opinions expressed by the bloggers are their own, and do not necessarily reflect the views of Cancer Network or its parent company, UBM Medica, LLC.